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1
00:00:07,057 --> 00:00:09,719
Previously on ER...
2
00:00:09,893 --> 00:00:12,191
I like kids.
3
00:00:12,362 --> 00:00:14,830
Fear of flying cannot be conquered.
4
00:00:14,998 --> 00:00:18,297
Mom got her real-estate license at 40.
I helped with her homework.
5
00:00:18,435 --> 00:00:20,699
I can help you with yours if you want.
6
00:00:20,870 --> 00:00:24,306
You're probably too tired
after your trip to dance.
7
00:00:24,474 --> 00:00:26,567
- Kind of, but...
- So maybe later.
8
00:00:26,776 --> 00:00:28,676
Do you know what you're doing or not?
9
00:00:28,845 --> 00:00:31,370
If you have to keep confirming,
you don't know what you're doing.
10
00:00:31,581 --> 00:00:33,572
I worked just as hard
as everyone else.
11
00:00:33,750 --> 00:00:36,878
You have to work twice as hard, stay
twice as late to be twice as good.
12
00:00:42,058 --> 00:00:43,616
Oh, God!
13
00:00:43,793 --> 00:00:47,752
The flight rotation was
the highlight of my residency.
14
00:00:47,931 --> 00:00:52,834
I'll be thousands of feet in the air
in something shaped like a potato.
15
00:00:52,969 --> 00:00:55,836
Well, actually,
it's only hundreds of feet.
16
00:00:59,909 --> 00:01:01,536
Oh, God!
17
00:01:03,613 --> 00:01:06,980
Don't they have
ambulances in this sticks?
18
00:01:07,150 --> 00:01:10,745
They don't have a trauma center
in Boone County. If it's bad, we go.
19
00:01:10,920 --> 00:01:14,185
- How far?
- Fifty, 60 miles.
20
00:01:14,357 --> 00:01:20,421
Head up. Didn't you know this
was a requirement of your residency?
21
00:01:20,597 --> 00:01:25,000
All right, deep breath.
Let it out slowly.
22
00:01:26,002 --> 00:01:28,903
Okay. My knees won't move!
23
00:01:29,072 --> 00:01:31,540
Come on. Stay low.
24
00:01:42,919 --> 00:01:47,618
- Dee McManus, Susan Lewis.
- Hi. First flight?
25
00:01:56,232 --> 00:02:00,566
The sum of the angles of a triangle
equals 180 degrees, right?
26
00:02:00,703 --> 00:02:04,366
- Hey, Carol.
- Hi, Doug.
27
00:02:04,574 --> 00:02:08,032
- Hi.
- Doug Ross, this is William Litman.
28
00:02:08,244 --> 00:02:12,772
- William is my lab partner.
- No kidding?
29
00:02:12,949 --> 00:02:14,041
How's it going?
30
00:02:14,217 --> 00:02:18,381
I have an intuitive 19th-century
Euclidean mind.
31
00:02:18,555 --> 00:02:22,685
It's actually crippling to the
understanding of the geometric...
32
00:02:22,859 --> 00:02:26,056
- I'm flunking out.
- What are you working on?
33
00:02:26,229 --> 00:02:32,361
String theory. The multi-dimensional
curvature of time and space.
34
00:02:32,502 --> 00:02:36,063
The Riemannian manifold is
"M" dimensional space...
35
00:02:36,239 --> 00:02:38,764
...that locally looks
like "N" dimensional space...
36
00:02:38,975 --> 00:02:42,206
...when "M" is less than "N."
37
00:02:49,552 --> 00:02:53,648
Susan, take a look. It's beautiful.
38
00:02:53,823 --> 00:02:57,850
- What are you doing?
- Hyperventilating. Leave me alone.
39
00:02:59,863 --> 00:03:05,358
You should really check out this view.
It helps you set your gyroscope.
40
00:03:06,369 --> 00:03:08,337
- What was that?
- The pilot.
41
00:03:08,504 --> 00:03:14,340
He was just adjusting
the rotor pitch. Absolutely normal.
42
00:03:14,510 --> 00:03:17,274
Right. Normal.
43
00:03:18,381 --> 00:03:20,747
There it is.
44
00:03:23,052 --> 00:03:27,011
Oh, man! We're first on scene.
45
00:03:27,190 --> 00:03:29,249
We're gonna need
the O-neg and blood Y's.
46
00:03:29,425 --> 00:03:31,893
There's a field near 5:00.
47
00:03:32,061 --> 00:03:34,495
Oh, God!
48
00:04:02,525 --> 00:04:04,789
Stay low and watch the tail rotors.
49
00:04:04,961 --> 00:04:09,022
We've got five victims.
Hay truck and a van hit head-on.
50
00:04:09,198 --> 00:04:11,359
Two ejected and three are trapped.
51
00:04:11,501 --> 00:04:14,334
- Where is the fire response?
- Two engines and an ambulance en route.
52
00:04:14,504 --> 00:04:17,302
- ETA?
- Thirty minutes.
53
00:04:17,507 --> 00:04:20,135
Triage first.
Susan, you check the car.
54
00:04:26,182 --> 00:04:29,117
It's all right, sweetie.
55
00:04:32,388 --> 00:04:34,982
Please get us out of this car!
56
00:05:25,942 --> 00:05:29,537
Yes, I'm still holding
for authorization. Hello?
57
00:05:29,746 --> 00:05:32,271
Dallas by three, you think?
58
00:05:32,448 --> 00:05:34,177
ER. Hold on.
59
00:05:34,350 --> 00:05:38,753
ICU's got no beds till 1999,
and they're sending us two vents.
60
00:05:38,921 --> 00:05:41,321
Way to go, Mr. Gomez!
61
00:05:41,491 --> 00:05:43,288
Chuny, we need
more IVAC's in 3.
62
00:05:43,459 --> 00:05:46,690
Patric Brazil,
metastatic prostate cancer.
63
00:05:46,863 --> 00:05:50,697
Cough, fever, two months
progressive weakness.
64
00:05:50,867 --> 00:05:55,804
Gave 300 cc's of saline.
He's a no-code.
65
00:05:55,938 --> 00:05:59,704
I've been Mr. B's
caretaker for 22 years.
66
00:05:59,909 --> 00:06:03,572
He wants to be cryogenically preserved
when he deanimates.
67
00:06:03,746 --> 00:06:07,807
- He wants to what?
- Be put on ice when he croaks.
68
00:06:07,984 --> 00:06:12,387
He's been waiting eight years to join
Mrs. B in their suspension capsule.
69
00:06:14,590 --> 00:06:16,956
His wife's been frozen
for eight years?
70
00:06:17,126 --> 00:06:22,928
It was their 50th anniversary
present to each other.
71
00:06:23,099 --> 00:06:27,126
They want to be preserved so that
they could come back in the future.
72
00:06:27,270 --> 00:06:30,831
Just like those dinosaurs
in that movie.
73
00:06:31,040 --> 00:06:33,600
Isn't it romantic?
74
00:06:33,810 --> 00:06:38,372
Let's hang a dobutamine drip.
Start at 10 mcg per kilo...
75
00:06:38,548 --> 00:06:40,982
- Watch the IV.
- Settle down, Mr. Sotcheck.
76
00:06:41,150 --> 00:06:43,983
Rescue 1-16 for you to rule out MI.
77
00:06:44,153 --> 00:06:48,089
- We're swamped.
- Who's covering Haleh's vacation?
78
00:06:48,257 --> 00:06:52,023
The last nurse who floated down here
hid in the bathroom.
79
00:06:52,195 --> 00:06:54,857
- Sterling from Med-Surg West.
- Rhonda Sterling?
80
00:06:55,031 --> 00:06:58,660
- Yeah, what's wrong with her?
- She's a floor nurse.
81
00:06:58,801 --> 00:07:02,032
- I'm not babysitting her.
- Me neither.
82
00:07:04,207 --> 00:07:05,606
The fire's out!
83
00:07:05,775 --> 00:07:08,903
- What's your name?
- Gail. She's only 10 days old.
84
00:07:09,112 --> 00:07:13,071
- Is she all right?
- She's moving and crying.
85
00:07:13,916 --> 00:07:17,181
- I'm Dr. Lewis. What's your name?
- Zach.
86
00:07:17,353 --> 00:07:20,584
- Gail, does your neck hurt?
- Is he all right?
87
00:07:20,756 --> 00:07:22,621
Get a C-collar on her.
88
00:07:22,792 --> 00:07:25,488
Sir? Sir, can you hear me?
89
00:07:25,661 --> 00:07:28,630
It's brain matter. The guy's a goner.
90
00:07:38,274 --> 00:07:40,435
Get him on oxygen.
91
00:07:51,587 --> 00:07:54,613
Where, Zach? Your neck?
92
00:07:55,591 --> 00:07:57,889
Does this hurt?
93
00:07:58,060 --> 00:08:01,621
David? Where's my husband?
94
00:08:01,797 --> 00:08:04,664
Gail, where are you hurt?
95
00:08:04,800 --> 00:08:09,328
My right leg and my side.
David. Please!
96
00:08:09,505 --> 00:08:13,236
- Dr. Greene's working on him.
- My husband is a doctor.
97
00:08:13,442 --> 00:08:16,343
He has to check on the children.
98
00:08:16,512 --> 00:08:18,980
- He's a pediatrician.
- Go, I'll stand by.
99
00:08:19,182 --> 00:08:22,845
Okay, I'm gonna
go check on your husband.
100
00:08:28,891 --> 00:08:31,587
The trucker's gone.
I need you here.
101
00:08:31,761 --> 00:08:33,285
He's still moving.
102
00:08:33,462 --> 00:08:36,295
He's pulseless
with massive head trauma.
103
00:08:36,465 --> 00:08:40,424
I've got a tension hemopneumo
that we can save.
104
00:08:41,437 --> 00:08:43,405
Needle him, left side.
105
00:08:48,878 --> 00:08:51,278
He's decompressing.
106
00:08:57,620 --> 00:09:00,384
Thirty-two French.
107
00:09:00,556 --> 00:09:02,786
This guy's a pediatrician.
108
00:09:02,959 --> 00:09:05,826
- Really?
- His family's in the van.
109
00:09:05,995 --> 00:09:08,020
Wife and newborn baby girl.
110
00:09:08,197 --> 00:09:12,156
Wife's stable.
There's a boy about 8 years old.
111
00:09:12,301 --> 00:09:15,600
Number four-two facial fracture.
I'm worried about his airway.
112
00:09:15,771 --> 00:09:18,001
I'm in. Hook it up to the Foley bag.
113
00:09:18,207 --> 00:09:19,936
He's hemorrhaging.
114
00:09:20,142 --> 00:09:22,406
Grab two units
O-neg out of the cooler.
115
00:09:22,578 --> 00:09:24,637
I'll start a line.
116
00:09:26,515 --> 00:09:29,643
- What about my husband?
- Gail, we're getting you out.
117
00:09:29,819 --> 00:09:32,788
Yeah, I'm still holding.
118
00:09:33,823 --> 00:09:38,522
Do you like Green Bay
minus seven over Washington?
119
00:09:38,694 --> 00:09:41,925
- Excuse me.
- Hang on one second.
120
00:09:44,166 --> 00:09:47,067
Please don't tell!
Mommy!
121
00:09:47,236 --> 00:09:49,500
Where do you want him?
122
00:09:49,672 --> 00:09:52,869
Curtain Area 3. End of the hall.
123
00:09:53,075 --> 00:09:55,202
Don't tell her!
124
00:10:01,984 --> 00:10:05,511
- Carol Hathaway?
- Carol.
125
00:10:07,590 --> 00:10:10,718
I was pulled off my ward
and assigned down here.
126
00:10:10,893 --> 00:10:12,656
What patient do you want me to take?
127
00:10:12,828 --> 00:10:17,424
Actually, we share our patients here.
Let me show you.
128
00:10:18,434 --> 00:10:21,597
Here are the patients
that are waiting to be seen.
129
00:10:21,771 --> 00:10:24,831
Nursing orders are flagged
and put over here, so when you're...
130
00:10:25,041 --> 00:10:29,102
I'll take Mr. Washington.
Where is Curtain Area 3?
131
00:10:29,312 --> 00:10:31,246
- There.
- Thank you.
132
00:10:35,985 --> 00:10:39,546
- Secure his head.
- We need to start a second line.
133
00:10:39,722 --> 00:10:42,885
Dr. Lewis!
The boy's stopped breathing.
134
00:10:43,059 --> 00:10:44,686
Go!
135
00:10:45,161 --> 00:10:47,129
Watch his C-spine!
136
00:10:51,400 --> 00:10:53,698
Keep in-line traction.
137
00:10:55,738 --> 00:10:58,536
You're in the way.
138
00:10:58,741 --> 00:11:02,837
Too much blood. I need suction.
6.0 tube.
139
00:11:04,580 --> 00:11:08,744
- Another 6.0.
- That was it.
140
00:11:08,918 --> 00:11:12,115
Okay, 5.5.
141
00:11:12,288 --> 00:11:14,119
Mark, I need your help.
142
00:11:14,290 --> 00:11:16,588
Get him on the chopper.
143
00:11:17,860 --> 00:11:20,590
We're taking care of him, Gail.
144
00:11:21,430 --> 00:11:26,265
Please don't let him die!
145
00:11:26,402 --> 00:11:28,927
- I can't see. Turn it up.
- It is up.
146
00:11:29,105 --> 00:11:32,074
There's better control in the chopper.
147
00:11:34,977 --> 00:11:38,469
Ready? One, two, three.
148
00:11:41,050 --> 00:11:45,282
- Doctor, I need you to start this IV.
- Okay.
149
00:11:46,322 --> 00:11:49,450
Go on, I'll check it out.
150
00:11:49,625 --> 00:11:51,684
- What's up?
- She needs an IV.
151
00:11:51,861 --> 00:11:55,319
Usually we try a few times
before we call a doc.
152
00:11:55,498 --> 00:11:59,798
Up in Med-Surg
we call the doctor when we miss.
153
00:11:59,935 --> 00:12:05,931
I'll do it. Mrs. Fesmire needs
20 of KCL in her IV in 3.
154
00:12:06,142 --> 00:12:11,079
- Where's the potassium?
- In the Med Room under "P."
155
00:12:14,383 --> 00:12:17,875
I can see the vocal cords.
I'm in.
156
00:12:23,292 --> 00:12:26,261
- I'll be right back.
- Susan!
157
00:12:26,429 --> 00:12:29,091
All right, Fred, fire it up.
158
00:12:29,265 --> 00:12:30,732
Susan!
159
00:12:33,636 --> 00:12:37,163
- How much longer?
- 20 or 30 minutes.
160
00:12:38,974 --> 00:12:44,879
Gail, we're taking your son and your
husband to County General Hospital.
161
00:12:45,047 --> 00:12:48,244
- Are they all right?
- They need to go to a trauma center.
162
00:12:48,417 --> 00:12:51,682
- How will I know what's happening?
- I will get word to you, Gail.
163
00:12:51,854 --> 00:12:54,414
- Please!
- I promise.
164
00:13:04,433 --> 00:13:07,163
- Are you okay?
- Yeah.
165
00:13:32,761 --> 00:13:36,162
- It's Dr. Greene from the whirlybird.
- Where's Mrs. Fesmire's potassium?
166
00:13:36,332 --> 00:13:39,267
I'm on break. I'm getting to her.
167
00:13:39,401 --> 00:13:41,562
This is County General on Beta-two.
Go ahead.
168
00:13:41,737 --> 00:13:47,141
We're incoming on Air-vac Onewith two major traumas.
169
00:13:47,309 --> 00:13:50,210
Grab Lydia and Chuny.
Tell them to clear the trauma rooms.
170
00:13:50,379 --> 00:13:52,847
- Go ahead, Air-Vac One.
- I'm gonna need a vent...
171
00:13:54,483 --> 00:13:57,111
Goodbye, Mr. B.
172
00:14:03,926 --> 00:14:08,522
You will keep him cold
until they come for him, won't you?
173
00:14:09,565 --> 00:14:13,865
So that he could be with his wife.
174
00:14:14,003 --> 00:14:16,403
- Please?
- Sure.
175
00:14:19,275 --> 00:14:21,607
Should I clean out the fridge?
176
00:14:37,560 --> 00:14:42,327
The dad's got
a hemopneumo and a head trauma.
177
00:14:42,498 --> 00:14:47,458
7-year-old had an obstructed
airway. He's getting shocky.
178
00:14:49,939 --> 00:14:52,169
- Good job, Susan.
- What?
179
00:14:52,374 --> 00:14:54,604
I said good job.
180
00:14:54,810 --> 00:14:56,710
Draw up meds.
181
00:14:57,947 --> 00:15:00,541
Watch that IV. Fluids wide open.
182
00:15:00,716 --> 00:15:05,415
Let's get a cross-table, CBC,
type and cross for four units...
183
00:15:05,588 --> 00:15:08,421
Draw up a saline-flush crash cart.
184
00:15:09,458 --> 00:15:13,827
- Where is the saline?
- Pulse 160, thready...
185
00:15:13,996 --> 00:15:16,055
- He's waking up.
- Hey, Zach.
186
00:15:16,231 --> 00:15:19,928
That tube in your throat
is helping you breathe.
187
00:15:20,069 --> 00:15:23,596
- Set up for lavage.
- Want a gas?
188
00:15:23,806 --> 00:15:26,297
Got it. You bet.
189
00:15:33,549 --> 00:15:36,279
Chuny, give me a hand right here.
190
00:15:38,721 --> 00:15:42,350
Okay, we got a bloody tap.
Page Benton.
191
00:15:42,524 --> 00:15:45,687
See if the dad will sign
a consent form for an ex-lap.
192
00:15:46,228 --> 00:15:49,994
- Put that O-neg on the rapid infuser.
- Is he conscious?
193
00:15:50,132 --> 00:15:53,829
He's responding to pain.
Dr. Herlihy, open your eyes.
194
00:15:55,671 --> 00:15:58,936
Somebody needs to sign
his son's surgical consent.
195
00:15:59,141 --> 00:16:01,871
BP's low, 70 palp.
Pulse ox is only 85.
196
00:16:02,077 --> 00:16:04,739
Ask Jerry to track down
the number of the hospital...
197
00:16:04,913 --> 00:16:08,610
...in Boone County where they're
taking the mother and the baby.
198
00:16:08,784 --> 00:16:10,979
Do the heart sounds
seem distant to you?
199
00:16:11,153 --> 00:16:13,553
Tamponade?
200
00:16:13,722 --> 00:16:16,418
- Hang in there, Zach.
- Hold him still.
201
00:16:16,592 --> 00:16:20,358
- He's gotta be sedated.
- Give him Versed, one milligram IV.
202
00:16:20,529 --> 00:16:22,497
Where is it?
203
00:16:23,966 --> 00:16:26,935
It's clotted.
I need that saline.
204
00:16:27,102 --> 00:16:28,763
- Another liter.
- Let's go!
205
00:16:28,937 --> 00:16:33,397
Zach, I'm gonna give you
something to help you sleep, okay?
206
00:16:33,609 --> 00:16:35,304
Hold him.
207
00:16:36,645 --> 00:16:38,840
What was that? Did it hurt?
208
00:16:39,014 --> 00:16:40,948
Are you sure that's saline?
209
00:16:43,318 --> 00:16:47,311
- Oh, my God! That's potassium.
- How much went in?
210
00:16:47,489 --> 00:16:49,684
- About a quarter cc.
- Insulin and glucose.
211
00:16:49,858 --> 00:16:53,089
- Where is it?
- Second drawer.
212
00:16:53,262 --> 00:16:57,494
Hold on. It's probably
not enough to stop his heart.
213
00:16:59,635 --> 00:17:00,727
I think we're gonna be okay.
214
00:17:00,903 --> 00:17:04,669
- What do you got?
- 7-year-old TC.
215
00:17:04,873 --> 00:17:08,969
Airway compromised at the scene.
Peritoneal lavage was positive.
216
00:17:12,047 --> 00:17:17,041
- BP's crashing, 60 palp.
- Pericardiocentesis tray.
217
00:17:17,219 --> 00:17:20,052
- Go ahead.
- I'll drop the central line.
218
00:17:20,222 --> 00:17:24,625
Hook an alligator clip
to an EKG lead. Use V-1.
219
00:17:25,661 --> 00:17:27,686
Not mine.
220
00:17:28,731 --> 00:17:30,562
It's the patient's.
221
00:17:30,699 --> 00:17:34,499
He's a doctor. It might be his office.
Why don't you dial the number?
222
00:17:34,670 --> 00:17:37,230
Jerry called Dwight Hospital.
The baby and wife haven't arrived.
223
00:17:37,406 --> 00:17:40,432
- Are they on their way?
- I don't know.
224
00:17:42,544 --> 00:17:44,341
- What do we have?
- Blunt abdominal trauma.
225
00:17:44,513 --> 00:17:48,210
Hypotensive intraperitoneal hemorrhage
confirmed by lavage.
226
00:17:48,383 --> 00:17:52,479
Facial trauma intubated in the field
with an RSI. H&H is 11, 32.
227
00:17:52,654 --> 00:17:55,987
Type and cross four, 650 cc's
of saline. We're set onboard.
228
00:17:56,158 --> 00:17:58,888
- Way to go, Carter!
- Let's take him up.
229
00:17:59,061 --> 00:18:01,655
Where are his parents?
230
00:18:01,830 --> 00:18:03,695
Second unit's in.
231
00:18:03,866 --> 00:18:09,168
So you got his partner to take calls?
Okay, we'll let you know.
232
00:18:10,372 --> 00:18:15,708
Forty cc's non-clotting blood, out.
233
00:18:15,878 --> 00:18:20,611
Dr. Herlihy, you've been
in an accident. You're in the ER.
234
00:18:21,650 --> 00:18:24,642
BP's back up, 120 over 80.
235
00:18:24,820 --> 00:18:27,846
I'm worried about
an intracranial bleed.
236
00:18:28,023 --> 00:18:30,287
- The nurse goes with him.
- Am I on call?
237
00:18:30,459 --> 00:18:36,227
You're a patient.
You were involved in traffic accident.
238
00:18:36,398 --> 00:18:39,834
Your son, Zach, has just
been taken up to surgery.
239
00:18:39,968 --> 00:18:43,597
- Surgery?
- He was injured in the accident.
240
00:18:43,772 --> 00:18:45,399
What accident?
241
00:18:46,074 --> 00:18:48,167
Get a rush on that head CT.
242
00:18:48,377 --> 00:18:51,312
Zach, everything's gonna be okay.
243
00:18:59,922 --> 00:19:03,016
- We could've killed that boy.
- I got confused.
244
00:19:03,258 --> 00:19:08,025
- You have no business working the ER.
- You think I don't know that?
245
00:19:08,197 --> 00:19:11,826
I want you to restock supplies
for the rest of the day.
246
00:19:11,967 --> 00:19:15,528
This is Carol Hathaway in the ER.
Clear a CT room, please.
247
00:19:19,808 --> 00:19:23,107
Where's the number
for chopper dispatch?
248
00:19:27,182 --> 00:19:29,241
Mark, can I run something past you?
249
00:19:29,418 --> 00:19:34,378
A guy died, and I don't know what to do
about his cryogenics request.
250
00:19:34,556 --> 00:19:38,390
He and his wife bought a tank so
they could be frozen when they died.
251
00:19:38,560 --> 00:19:42,428
- Where is his wife now?
- In the tank.
252
00:19:42,598 --> 00:19:46,694
I have an number for
a cryogenics company in California.
253
00:19:48,203 --> 00:19:51,001
Yeah, still holding.
254
00:19:57,246 --> 00:20:00,511
- What?
- Nothing.
255
00:20:01,783 --> 00:20:04,752
Page me as soon as you know.
256
00:20:05,787 --> 00:20:09,917
The helicopter's standing by.
We may have to get the wife and baby.
257
00:20:11,927 --> 00:20:15,556
- Okay, DeBakey.
- 5.0 Prolene on a Castroviejo.
258
00:20:15,731 --> 00:20:17,892
- Retract caudally.
- Retractor.
259
00:20:18,033 --> 00:20:21,662
Splenic vein's repaired.
What about this pancreas?
260
00:20:21,837 --> 00:20:25,864
I'd resect rather than
do a subtotal pancreatectomy.
261
00:20:26,074 --> 00:20:30,568
I agree. Metz.
How would you repair after resection?
262
00:20:30,779 --> 00:20:35,614
Interrupted horizontal mattresses and
a figure eight in the pancreatic duct.
263
00:20:35,784 --> 00:20:39,652
- 3.0 silk on a needle driver.
- Anything else to do?
264
00:20:39,821 --> 00:20:41,755
Irrigate. Run the bowel under control.
265
00:20:41,924 --> 00:20:45,155
Insert a Jackson-Pratt drain
through a separate stab wound.
266
00:20:45,327 --> 00:20:49,354
And use cautery instead of a scalpel
to minimize bleeding.
267
00:20:49,531 --> 00:20:53,934
- Then close.
- Do exactly what you just described.
268
00:20:54,069 --> 00:20:58,233
All right, cut the suture
three millimeters, no longer.
269
00:20:58,440 --> 00:21:01,409
Irrigate. Normal saline.
Make sure it's warm.
270
00:21:04,947 --> 00:21:07,177
Park her in the hall
till we can clear an exam room.
271
00:21:07,349 --> 00:21:10,682
- Have you seen Susan?
- She got paged to chopper duty.
272
00:21:17,025 --> 00:21:20,517
- What's up?
- I need ice, lots of ice.
273
00:21:20,696 --> 00:21:25,497
California Cryonics said to put him
on ice until their local rep arrives.
274
00:21:25,634 --> 00:21:28,034
They better hurry.
275
00:21:29,671 --> 00:21:32,139
Dr. Lewis!
276
00:21:33,175 --> 00:21:38,408
- Susan, are you all right?
- Yeah, I want to bring them in.
277
00:21:38,580 --> 00:21:41,777
- I'll go.
- No, I'm fine.
278
00:21:41,950 --> 00:21:45,147
Really?
You can stay here with Herlihy.
279
00:21:45,320 --> 00:21:48,187
Dr. Lewis.
We gotta go.
280
00:22:14,116 --> 00:22:17,108
May I?
See your orders?
281
00:22:20,522 --> 00:22:24,424
John, take these to ICU
and make sure they're carried out...
282
00:22:24,593 --> 00:22:26,527
...as meticulously as written.
283
00:22:26,695 --> 00:22:29,994
Peter, care to join me
in a sarcoma resection?
284
00:22:30,132 --> 00:22:32,498
- Yeah, I'd love to.
- Good.
285
00:22:32,667 --> 00:22:36,831
Gant can cover any trauma calls.
Scrub in, in 45 minutes.
286
00:22:37,005 --> 00:22:39,235
Don't you just love her?
287
00:22:42,377 --> 00:22:46,677
- Where's Zach? Where's my husband?
- Your husband was unconscious.
288
00:22:46,848 --> 00:22:48,782
He woke up confused and disoriented.
289
00:22:48,984 --> 00:22:52,385
He has a head injury?
What about my son?
290
00:22:52,554 --> 00:22:56,388
- He's in surgery.
- Don't worry. They're in good hands.
291
00:22:56,558 --> 00:22:57,616
Move!
292
00:22:58,860 --> 00:23:00,828
Does this hurt?
293
00:23:03,031 --> 00:23:05,158
BP's okay, 115 over 65.
294
00:23:05,300 --> 00:23:10,067
Let's get a C-spine.
H&H, type and cross for four.
295
00:23:11,173 --> 00:23:14,540
- Good set of lungs on her.
- Respiratory rate's kind of high.
296
00:23:14,709 --> 00:23:17,735
- Who knows with all that crying?
- It's 60, pulse 160.
297
00:23:17,946 --> 00:23:22,508
Abdomen's distended.
She's been taking in a lot of air.
298
00:23:22,684 --> 00:23:26,848
Get a baby Gram,
CBC and a gas.
299
00:23:27,022 --> 00:23:31,482
Darling, are you hurt
or just mad at the world?
300
00:23:35,864 --> 00:23:38,298
- What'll it be?
- Do you believe in reincarnation?
301
00:23:38,433 --> 00:23:42,927
Next life I'm coming back
as Cindy Crawford.
302
00:23:43,105 --> 00:23:47,371
A deceased patient wants
to be cryogenically preserved.
303
00:23:47,576 --> 00:23:50,909
We gotta freeze a dead guy.
You got any ice?
304
00:23:51,079 --> 00:23:53,513
- Neck looks okay.
- CT was normal.
305
00:23:53,715 --> 00:23:56,149
Dad's still altered,
they're doing an MRI.
306
00:23:56,318 --> 00:24:00,345
- Why did they take Megan away?
- She's just next door.
307
00:24:00,522 --> 00:24:03,855
- Zach's out of surgery.
- He's gonna be all right?
308
00:24:04,025 --> 00:24:06,858
He's in ICU.
I'll check on him as soon as I can.
309
00:24:07,028 --> 00:24:10,395
Oh, God! I need my husband.
310
00:24:10,565 --> 00:24:13,659
Please. Where is David?
311
00:24:16,138 --> 00:24:20,598
- Her abdomen's kind of firm.
- She swallowed a lot of air.
312
00:24:20,809 --> 00:24:23,869
- What shall we do?
- What is it, Gant?
313
00:24:24,079 --> 00:24:27,276
Her abdomen's persistently distended.
She keeps crying.
314
00:24:27,449 --> 00:24:30,509
Her resps are high.
The BP, the pulses and color are okay.
315
00:24:30,685 --> 00:24:33,779
- Why didn't you drop an NG?
- We considered it...
316
00:24:33,955 --> 00:24:37,618
- In such a small baby?
- Do it off the rectal thermometer.
317
00:24:37,792 --> 00:24:42,752
You didn't do a full surgical
evaluation of the patient, Dr. Gant.
318
00:24:45,433 --> 00:24:47,731
It's positive for blood.
Prep a cutdown tray.
319
00:24:47,903 --> 00:24:50,098
Type and cross for two units
and page Keaton.
320
00:24:50,272 --> 00:24:53,435
- Where's her mother?
- Trauma 1.
321
00:24:53,642 --> 00:24:56,907
Dr. Ross and I thought
it was an equivocal exam.
322
00:24:57,078 --> 00:24:59,876
If you don't know what you're doing,
call someone who does.
323
00:25:00,048 --> 00:25:02,278
Hi, I'm Dr. Benton.
324
00:25:02,450 --> 00:25:05,908
Your daughter has internal injuries
that's gonna require an operation.
325
00:25:06,087 --> 00:25:08,214
She's only 10 days old.
326
00:25:08,390 --> 00:25:10,756
It's okay.
Dr. Keaton will be with her.
327
00:25:10,926 --> 00:25:13,895
And she's the best
pediatric surgeon in Chicago.
328
00:25:14,062 --> 00:25:17,896
We need your consent
for an exploratory laparotomy.
329
00:25:18,033 --> 00:25:21,002
Where's my husband?
I want him to sign for it.
330
00:25:21,169 --> 00:25:24,332
Her husband's a pediatrician.
He can't do it right now.
331
00:25:24,506 --> 00:25:28,340
He handles all
the family medical decisions.
332
00:25:29,211 --> 00:25:32,180
- You can do this, Gail.
- But I don't know.
333
00:25:32,380 --> 00:25:35,110
Your baby needs it.
334
00:25:39,321 --> 00:25:41,289
Okay.
335
00:25:46,895 --> 00:25:50,092
Cutdown tray. Use a volutrol.
We may have to transfuse.
336
00:25:50,265 --> 00:25:52,665
Gant was on track.
I talked him out of it.
337
00:25:52,801 --> 00:25:54,769
Hang D5, 40 normal.
338
00:25:54,936 --> 00:25:58,895
- What do you think, Peter?
- She has an acute abdomen.
339
00:25:59,107 --> 00:26:01,302
Hi, pretty girl.
340
00:26:01,509 --> 00:26:05,070
- Vitals?
- BP's 80 over 40, pulse 160.
341
00:26:05,280 --> 00:26:08,215
Resps 65, temp's 101.4.
342
00:26:08,416 --> 00:26:12,409
- Oh, what blue, blue eyes!
- 92 room air.
343
00:26:13,955 --> 00:26:16,219
Teacup, that's too low.
344
00:26:16,391 --> 00:26:20,122
Let's get her on O-2,
four liters by mask.
345
00:26:21,396 --> 00:26:23,990
Did you appreciate
the periumbilical redness?
346
00:26:24,132 --> 00:26:26,930
- The abdomen's a little tight.
- No, I missed it.
347
00:26:27,102 --> 00:26:29,195
Well, it's easy to miss.
348
00:26:29,371 --> 00:26:31,100
- Why a cutdown?
- No veins.
349
00:26:31,306 --> 00:26:34,935
Twenty-two angio.
This was a nice pickup, Peter.
350
00:26:35,143 --> 00:26:37,077
Thank you.
351
00:26:38,146 --> 00:26:41,547
Ah, yes. There we go.
352
00:26:42,450 --> 00:26:45,010
I couldn't see or feel a vein.
353
00:26:45,186 --> 00:26:48,155
It's just a matter
of knowing where it is.
354
00:26:48,323 --> 00:26:52,123
Let's get her a cross-table lateral
and check for free air.
355
00:26:52,294 --> 00:26:54,262
- Any thoughts on antibiotics?
- Since you don't need...
356
00:26:54,429 --> 00:26:58,763
...anaerobic coverage on newborns,
I'd go with amp and gent.
357
00:26:58,900 --> 00:27:02,358
Dennis, since you did the trauma
assessment, why don't you scrub in?
358
00:27:02,537 --> 00:27:04,630
Peter, let's go talk to Mom.
359
00:27:11,146 --> 00:27:12,511
Good girl.
360
00:27:19,220 --> 00:27:22,587
There you go, Mr. Brazil.
Shrimp cocktail time.
361
00:27:22,757 --> 00:27:26,693
Hubert Skinner, California Cryonics.
Mr. Brazil.
362
00:27:26,861 --> 00:27:30,592
- You got some kind of I.D.?
- It's all there.
363
00:27:30,765 --> 00:27:33,700
Give him
10,000 units of heparin stat.
364
00:27:33,835 --> 00:27:37,236
I'll pack him up,
and we'll be on our way.
365
00:27:37,405 --> 00:27:40,431
- Is he a doctor?
- I don't think so. What do we do?
366
00:27:40,642 --> 00:27:43,042
The heparin can't hurt,
him being dead and all.
367
00:27:43,211 --> 00:27:47,477
In the newborn, I use
a transverse abdominal incision.
368
00:27:47,649 --> 00:27:50,777
The rectus is thin
so there's less pain post-op.
369
00:27:51,820 --> 00:27:54,948
We're using a respirator,
so atelectasis isn't an issue.
370
00:27:55,123 --> 00:27:56,886
Zap that little bleeder.
371
00:27:57,058 --> 00:27:58,719
- Cautery.
- Fifteen blade.
372
00:27:58,893 --> 00:28:00,292
If there's a perforation...
373
00:28:00,462 --> 00:28:04,762
...we should get a gush of air
when I nick the peritoneum.
374
00:28:04,899 --> 00:28:08,096
- There it is.
- She's easier to ventilate.
375
00:28:08,269 --> 00:28:10,533
Dennis, why do we want
to keep bleeding to a minimum?
376
00:28:10,705 --> 00:28:12,673
Transfusions are dangerous.
377
00:28:12,874 --> 00:28:16,435
You can't type and cross-match blood
because of the fetal hemoglobin.
378
00:28:16,644 --> 00:28:21,809
There it is. Perfed jejunum.
You're teaching your interns well.
379
00:28:25,553 --> 00:28:28,454
He's in and out. MRI was normal.
380
00:28:28,623 --> 00:28:31,615
Dr. Herlihy,
do you remember my name?
381
00:28:32,660 --> 00:28:35,390
- Where's my wife and kids?
- I'm Mark Greene.
382
00:28:35,563 --> 00:28:38,088
Your family was involved
in a traffic accident.
383
00:28:38,233 --> 00:28:40,963
Your wife's in the ER,
with a tib-fib fracture.
384
00:28:41,136 --> 00:28:44,196
Zach had facial trauma
and hemoperitoneum.
385
00:28:44,372 --> 00:28:46,272
He's out of surgery in ICU.
386
00:28:46,474 --> 00:28:49,602
- Was it his spleen?
- No. Pancreatic injury.
387
00:28:49,811 --> 00:28:51,244
What about Megan?
388
00:28:51,413 --> 00:28:55,179
Megan just went up
to rule out intestinal perforation.
389
00:28:55,350 --> 00:28:57,580
Why? What happened to her?
390
00:28:57,752 --> 00:29:00,915
She was in the accident with you.
391
00:29:01,089 --> 00:29:03,717
What accident?
392
00:29:03,892 --> 00:29:05,883
Do you know my name?
393
00:29:06,060 --> 00:29:08,187
No. Should I?
394
00:29:13,435 --> 00:29:15,266
It's okay.
395
00:29:15,870 --> 00:29:20,637
Gently. To repair it, we use
a 4.0 silk, interrupted Hufnagel.
396
00:29:20,842 --> 00:29:22,571
Field looks dry.
397
00:29:22,777 --> 00:29:25,177
You don't need
a two-layer in anastomosis.
398
00:29:25,346 --> 00:29:28,247
Cautery alone gives you hemostasis.
399
00:29:28,416 --> 00:29:29,974
Let's irrigate. Warm saline, please.
400
00:29:30,151 --> 00:29:32,551
Zach's abdomen is distending.
401
00:29:32,720 --> 00:29:35,951
- Any changes in his vitals or pulse?
- I think he's bleeding.
402
00:29:36,124 --> 00:29:40,220
Damn! Peter, do you think
you're ready to finish alone?
403
00:29:40,395 --> 00:29:42,590
- Yeah.
- Nothing fancy. Just close.
404
00:29:46,568 --> 00:29:50,197
All right, people. Let's go.
Thank you. One more.
405
00:29:51,072 --> 00:29:53,563
His abdomen is more distended.
406
00:29:53,775 --> 00:29:56,141
- Has he regained consciousness?
- No.
407
00:29:57,145 --> 00:30:00,546
Four-by-eight. Thank you.
408
00:30:01,883 --> 00:30:06,183
- All right. Completely dry.
- What's that?
409
00:30:07,222 --> 00:30:11,124
Looks like a little fiber and debris
on the liver surface.
410
00:30:11,292 --> 00:30:14,159
- Should I call Dr. Keaton?
- No. I'll clean it out.
411
00:30:19,234 --> 00:30:23,568
Okay, got it. Let's close
the peritoneum first. 3.0 Vicryl.
412
00:30:27,709 --> 00:30:31,543
Now, retract medially. Cut.
413
00:30:34,716 --> 00:30:35,978
Good.
414
00:30:36,150 --> 00:30:38,448
- There's a little blood.
- Where?
415
00:30:38,620 --> 00:30:42,078
Oozing from the liver
where you just touched it.
416
00:30:42,257 --> 00:30:47,217
I'll put a little pressure on it.
Use suction. Gently, okay?
417
00:30:53,201 --> 00:30:55,601
Damn it!
418
00:30:57,171 --> 00:30:59,401
- It's still oozing.
- I'm not closing while it's bleeding.
419
00:30:59,607 --> 00:31:03,839
I'll put a stitch in for hemostasis.
4.0 chromic on an S-H now.
420
00:31:06,714 --> 00:31:09,182
Retract caudally.
421
00:31:09,918 --> 00:31:12,478
Come on, Gant. Retractor.
422
00:31:15,056 --> 00:31:18,025
- Is Anesthesia standing by?
- I called them.
423
00:31:23,398 --> 00:31:28,495
- He is distended. Vitals?
- Stable. BP 90 over 60. Pulse is 96.
424
00:31:28,636 --> 00:31:32,367
Pulse ox is 99 percent.
Should I clear an O.R.?
425
00:31:32,574 --> 00:31:36,533
Hang on.
Disconnect the NG from the wall.
426
00:31:40,682 --> 00:31:45,142
Sometimes you get
an erosive gastritis. Hook it back up.
427
00:31:48,423 --> 00:31:51,221
Clots can block the NG
causing acute dilatation.
428
00:31:51,392 --> 00:31:54,828
Irrigate it out
and crisis resolved.
429
00:31:57,832 --> 00:32:00,801
It's just experience, doctor.
430
00:32:03,438 --> 00:32:05,463
- She's still bleeding!
- I can see that.
431
00:32:05,673 --> 00:32:08,233
I'll put a gelfoam
on the bleeding site.
432
00:32:08,443 --> 00:32:11,776
You apply pressure. Come on.
433
00:32:11,946 --> 00:32:14,574
- Do you want me to get Dr. Keaton?
- No.
434
00:32:14,749 --> 00:32:20,210
More suction. I'm gonna oversew.
2.0 chromic on an S-H.
435
00:32:20,388 --> 00:32:21,980
Heart rate's starting to fluctuate.
436
00:32:22,156 --> 00:32:24,647
Give me a bolus
of normal saline, 40 cc's.
437
00:32:24,826 --> 00:32:27,727
The liver's so fragile,
my stitch cut right through.
438
00:32:27,895 --> 00:32:30,329
I'm gonna take a bigger bite.
Retract this way.
439
00:32:30,465 --> 00:32:33,195
You need to get this baby
off the table.
440
00:32:33,368 --> 00:32:35,802
All right, bag her faster, damn it!
441
00:32:38,239 --> 00:32:40,207
- I'm getting Keaton.
- No!
442
00:32:40,375 --> 00:32:42,309
Go! Go!
443
00:32:47,782 --> 00:32:52,048
Do you think it'll help her
to see her husband like this?
444
00:32:54,555 --> 00:32:58,855
Megan's in surgery. Zach's in ICU.
Your husband got out of X-ray.
445
00:32:59,027 --> 00:33:01,621
- He's okay?
- His tests are normal, but...
446
00:33:01,796 --> 00:33:03,957
...there's still memory loss.
447
00:33:04,098 --> 00:33:06,259
Could it be permanent?
448
00:33:06,434 --> 00:33:09,926
You can see these things
in a concussion.
449
00:33:10,104 --> 00:33:14,370
- But it might be?
- We just have to wait and see.
450
00:33:15,443 --> 00:33:17,570
- Blood loss?
- A hundred cc's.
451
00:33:17,779 --> 00:33:20,373
One third of her volume.
What did you do to her liver?
452
00:33:20,548 --> 00:33:24,484
I was trying to peel away
some fiber and debris.
453
00:33:25,520 --> 00:33:27,078
Move.
454
00:33:27,255 --> 00:33:31,453
- 2.0 chromic on an S-H.
- It started to ooze. Clear.
455
00:33:31,626 --> 00:33:33,924
There's no way
to control the bleeding.
456
00:33:34,095 --> 00:33:37,394
Peter, handle the suction.
Dennis, retract distally.
457
00:33:37,532 --> 00:33:40,399
Cautery. Crank it up to 18.
458
00:33:40,568 --> 00:33:42,195
Pulse and BP are destabilizing.
459
00:33:42,370 --> 00:33:44,600
We have to transfuse
with unwashed O-neg.
460
00:33:44,806 --> 00:33:46,171
2.0 chromic. Keep them coming.
461
00:33:46,374 --> 00:33:48,774
She's bradying down. Rate's 80.
462
00:33:48,943 --> 00:33:52,709
3.0 Vicryl for the peritoneum
muscles and staples for the skin.
463
00:34:01,889 --> 00:34:03,823
David?
464
00:34:04,058 --> 00:34:06,322
Oh, my God! David.
465
00:34:06,494 --> 00:34:08,928
- What happened?
- Didn't you tell him?
466
00:34:09,097 --> 00:34:13,557
- We did. Many times.
- Zach's condition is stabilized.
467
00:34:13,701 --> 00:34:16,226
Zach?
468
00:34:16,404 --> 00:34:20,238
- What about Megan?
- Dr. Benton's closing right now.
469
00:34:20,441 --> 00:34:22,466
That's wonderful news.
470
00:34:23,544 --> 00:34:26,479
Was there a truck?
471
00:34:27,782 --> 00:34:32,185
Yeah. Yeah, there was a truck.
472
00:34:37,959 --> 00:34:40,587
- What were you thinking?
- There was debris.
473
00:34:40,762 --> 00:34:43,253
- I only told you to close.
- In my judgment...
474
00:34:43,431 --> 00:34:48,095
I didn't ask for your judgment!
Perry, Dennis, set up a vent.
475
00:34:49,103 --> 00:34:52,095
F-I O-2 at 100 percent.
Stand by with dopamine...
476
00:35:11,359 --> 00:35:15,591
- Does that say chicken belt?
- Conjunctivitis.
477
00:35:15,763 --> 00:35:18,391
I hate chart QA.
478
00:35:25,273 --> 00:35:28,902
- What?
- Nothing.
479
00:35:30,444 --> 00:35:33,413
Thanks for helping me in the chopper.
480
00:35:33,614 --> 00:35:36,242
No problem.
481
00:35:48,930 --> 00:35:51,125
Things can get pressured in here.
482
00:35:51,265 --> 00:35:55,429
It just isn't a place
for someone who is inexperienced.
483
00:35:56,470 --> 00:35:58,370
I can't have you work here again.
484
00:36:21,963 --> 00:36:23,954
Zach?
485
00:36:24,098 --> 00:36:26,498
Oh, God!
486
00:36:26,667 --> 00:36:29,227
- Can I touch him?
- Sure.
487
00:36:41,515 --> 00:36:44,484
Zach, honey, it's Mommy.
488
00:36:45,953 --> 00:36:50,083
I'm gonna stay right here
until you wake up.
489
00:36:56,831 --> 00:37:02,235
- What about Megan?
- No one from Surgery's talked to you?
490
00:37:03,237 --> 00:37:06,764
- I'll go find out what's going on.
- Thank you.
491
00:37:11,879 --> 00:37:15,280
- Why hasn't anyone talked to her?
- I don't know.
492
00:37:15,483 --> 00:37:17,110
Benton was closing over an hour ago.
493
00:37:19,186 --> 00:37:22,087
- Blood gas has improved.
- Not by much.
494
00:37:22,256 --> 00:37:25,384
Could you excuse us, Kit?
Dennis? Thank you.
495
00:37:26,594 --> 00:37:29,028
I should never
have left you unsupervised.
496
00:37:29,196 --> 00:37:33,462
There are nuances in neonatal surgery.
The liver's more friable.
497
00:37:33,601 --> 00:37:38,334
I wanted a clean field before
I closed. It seemed appropriate.
498
00:37:38,506 --> 00:37:43,534
What's at issue here is that you
ignored my specific instructions.
499
00:37:43,744 --> 00:37:45,769
I followed standard
operative procedures.
500
00:37:45,980 --> 00:37:48,448
I've done it a dozen times
in other patients.
501
00:37:48,649 --> 00:37:51,777
This is not an "other" patient.
This is an infant!
502
00:37:51,953 --> 00:37:53,978
Outside now.
503
00:37:59,293 --> 00:38:03,059
You don't know anything
about pediatric surgery.
504
00:38:03,230 --> 00:38:05,221
Are you unwilling
to learn from your mistakes?
505
00:38:05,366 --> 00:38:07,095
Does it say not to stitch a liver?
506
00:38:07,268 --> 00:38:12,035
You didn't know what you were doing.
You should've called me!
507
00:38:12,206 --> 00:38:13,969
Why did I find
three stitches in there?
508
00:38:14,175 --> 00:38:17,770
Because you arrogantly and blindly
think you have all the answers.
509
00:38:17,979 --> 00:38:20,413
If that baby dies,
it'll be my responsibility...
510
00:38:20,614 --> 00:38:23,674
...but it'll be your fault.
- Dr. Keaton, she's crashing.
511
00:38:24,285 --> 00:38:26,651
Pulse ox is 86.
Heart rate's down to 45.
512
00:38:26,821 --> 00:38:29,881
Decreased breath sounds on the right.
513
00:38:30,057 --> 00:38:32,423
Sounds like a pneumothorax.
Chest x-ray.
514
00:38:32,593 --> 00:38:34,561
Don't need it.
515
00:38:34,729 --> 00:38:37,493
Increase transillumination
on the right side.
516
00:38:37,631 --> 00:38:41,067
- Chest-tube tray.
- This is no longer a teaching case.
517
00:38:41,235 --> 00:38:45,001
- She's gonna need a repeat ABG.
- Pulse is up to 72.
518
00:38:45,206 --> 00:38:48,334
- Dynamap's not registering a BP.
- Get ready with Thermo-Seal.
519
00:38:49,210 --> 00:38:52,145
She's arresting.
Heart rate's down to 20.
520
00:38:52,313 --> 00:38:56,647
Let's start CPR.
Epi one to ten thousand point four.
521
00:38:56,817 --> 00:38:59,445
Atropine.08 milligrams.
How's the blood gas?
522
00:38:59,620 --> 00:39:03,249
PH 7.3. PO-245. PCO-230
on 100 percent oxygen.
523
00:39:03,424 --> 00:39:05,517
We have to put her
on an ECMO bypass.
524
00:39:05,693 --> 00:39:09,527
Kit, call the tech. Get
two units O-neg to prime the system.
525
00:39:09,697 --> 00:39:14,566
- Do we bring her back up to the O.R.?
- No, we'll bring the O.R. To her.
526
00:39:15,803 --> 00:39:17,600
Dr. Greene?
527
00:39:18,639 --> 00:39:20,266
Dr. Herlihy?
528
00:39:21,342 --> 00:39:24,277
- What time is it?
- Eight o'clock.
529
00:39:24,445 --> 00:39:27,346
P.M.?
Where's my family?
530
00:39:27,515 --> 00:39:31,110
Your wife's upstairs.
Both the kids had laparotomies.
531
00:39:31,285 --> 00:39:33,253
A bed opened up for you in ICU.
532
00:39:33,421 --> 00:39:35,446
How'd they do?
533
00:39:35,623 --> 00:39:39,616
Your son's out of surgery.
I don't know about your daughter.
534
00:39:39,794 --> 00:39:43,423
- How do I find out about my daughter?
- I'll check on her.
535
00:39:43,597 --> 00:39:45,963
- Thank you, Dr. Greene.
- Mark.
536
00:39:46,100 --> 00:39:47,658
Mark.
537
00:39:51,505 --> 00:39:55,999
Pedes O.R. Called. His daughter
decompensated in surgery.
538
00:40:12,493 --> 00:40:17,089
- She's still flatline.
- Repeat.04 of epi.
539
00:40:18,933 --> 00:40:22,130
Go ahead, Kit.
How long has she been down?
540
00:40:22,303 --> 00:40:24,498
Twenty-two minutes.
541
00:40:25,573 --> 00:40:28,406
- Is the ECMO circuit primed?
- Yes.
542
00:40:28,576 --> 00:40:31,670
Good. I'm ready.
Venous connection first.
543
00:40:33,047 --> 00:40:35,277
Arterial.
544
00:40:36,117 --> 00:40:38,085
Turn it on.
545
00:40:51,732 --> 00:40:55,759
- We've got a heartbeat and a pulse.
- Faint.
546
00:40:56,737 --> 00:40:57,829
She's pinking up.
547
00:40:58,005 --> 00:41:01,497
Let's get a repeat gas.
We need to anti-coagulate her.
548
00:41:01,709 --> 00:41:05,543
Heparin, 150 units IV.
Start drip at 10 units an hour.
549
00:41:05,713 --> 00:41:09,376
- How come we anti-coagulate her?
- We have to, or her blood will clot.
550
00:41:09,550 --> 00:41:12,178
- Won't she bleed out?
- We have to hope that she doesn't.
551
00:41:12,353 --> 00:41:16,119
I'll dictate an operative report.
Meet me in Pedes ICU in five minutes.
552
00:41:16,290 --> 00:41:18,588
We gotta tell the parents.
553
00:41:25,599 --> 00:41:28,466
Peter, how'd it go?
554
00:41:28,636 --> 00:41:32,265
- How's the baby?
- Not good.
555
00:41:37,778 --> 00:41:40,542
Dr. Benton...
556
00:41:40,714 --> 00:41:43,274
You didn't sign the code sheet.
557
00:41:46,987 --> 00:41:49,547
Hey, we're all human.
558
00:41:49,723 --> 00:41:51,748
We all make mistakes.
559
00:41:51,926 --> 00:41:55,555
Any other words of wisdom, Gant?
560
00:41:57,665 --> 00:42:00,759
You're a real prick, you know that?
561
00:42:03,204 --> 00:42:08,733
Mrs. Herlihy, this is Dr. Keaton.
She operated on both Zach and Megan.
562
00:42:08,943 --> 00:42:10,240
Mrs. Herlihy...
563
00:42:10,411 --> 00:42:14,074
Megan had a perforated intestine
from the accident.
564
00:42:14,248 --> 00:42:18,617
When we operated to repair it,
there were complications.
565
00:42:22,289 --> 00:42:26,988
- What are you saying?
- She's in the NICU on a device...
566
00:42:27,161 --> 00:42:31,063
...that helps her heart and lungs
oxygenate her blood.
567
00:42:31,198 --> 00:42:35,692
There was bleeding during
the operation, and she went into shock.
568
00:42:35,869 --> 00:42:39,669
Then her lung collapsed,
and finally, her heart stopped.
569
00:42:40,708 --> 00:42:44,109
We got it started again by
putting her on a bypass machine.
570
00:43:01,829 --> 00:43:04,320
Is she gonna die?
571
00:43:04,465 --> 00:43:06,933
She's in extremely critical condition.
572
00:43:07,101 --> 00:43:10,502
It's... It is a possibility.
573
00:44:17,237 --> 00:44:22,641
The Lord is my shepherd,
I shall not want.
574
00:44:24,611 --> 00:44:28,775
He makes me lie down
in green pastures.
575
00:44:28,949 --> 00:44:30,917
He...
576
00:44:34,688 --> 00:44:36,315
The Lord is my shepherd,
I shall not want.
577
00:44:36,490 --> 00:44:39,926
He makes me lie down
in green pastures. He's...
578
00:44:40,094 --> 00:44:42,062
Dr. Benton?
579
00:44:46,600 --> 00:44:49,569
I can't remember the words.
46514
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